MEDICARE: MS. ERIKA OLDHAM LCSW, LCAS, CSI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	C011116	NC
2	1041C0700X	Clinical Social Worker	P009613	NC

General Provider Information

NPI Number	:	1841736519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIKA OLDHAM LCSW, LCAS, CSI

Provider Business Mailing Address
First Line	:	102 SHELL LN
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-7941
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 BREWSTER BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540
Country	:	US
Telephone Number	:	910-358-8132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2017
Last Update Date	:	03/17/2026

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